title: A prospective randomized trial of intravitreal bevacizumab versus ranibizumab for the management of diabetic macular edema.
abstract: OBJECTIVE
  To compare visual acuity and spectral-domain optical coherence tomography (SDOCT) outcomes associated with intravitreal (IV) bevacizumab vs IV ranibizumab for the management of diabetic macular edema (DME).
  
  
  METHODS
  Prospective randomized trial.
  
  
  METHODS
  Forty-eight patients (63 eyes) with center-involved DME were randomly assigned to receive 1.5 mg (0.06 cc) IV bevacizumab or 0.5 mg (0.05 cc) IV ranibizumab at baseline and monthly if central subfield thickness was greater than 275 μm.
  
  
  RESULTS
  Forty-five patients (60 eyes) completed 48 weeks of follow-up. At baseline, mean ± standard error best-corrected visual acuity (BCVA) (logMAR) was 0.60 (20/80) ± 0.05 in the IV bevacizumab group and 0.63 (20/85) ± 0.05 in the IV ranibizumab group. A significant improvement in mean BCVA was observed in both groups at all study visits (P < .05); this improvement was significantly greater in the IV ranibizumab group compared with the IV bevacizumab group at weeks 8 (P = .032) and 32 (P = .042). A significant reduction in mean central subfield thickness was observed in both groups at all study visits compared with baseline (P < .05), with no significant difference in the magnitude of macular thickness reduction between groups. The mean number of injections was significantly higher (P = .005) in the IV bevacizumab group (9.84) than in the IV ranibizumab group (7.67).
  
  
  CONCLUSIONS
  IV bevacizumab and IV ranibizumab are associated with similar effects on central subfield thickness in patients with DME through 1 year of follow-up. IV ranibizumab is associated with greater improvement in BCVA at some study visits, and the mean number of injections is higher in the IV bevacizumab group.
authors.affiliation: School of Medicine of Ribeirão Preto, University of São Paulo, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto, Brazil.
authors.forename: Antonio Brunno
authors.initials: AB
authors.lastname: Nepomuceno
authors.affiliation: School of Medicine of Ribeirão Preto, University of São Paulo, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto, Brazil.
authors.forename: Erika
authors.initials: E
authors.lastname: Takaki
authors.affiliation: School of Medicine of Ribeirão Preto, University of São Paulo, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto, Brazil.
authors.forename: Felipe Piacentini
authors.initials: FP
authors.lastname: Paes de Almeida
authors.affiliation: Hospital de Olhos de Araraquara, Araraquara, Brazil.
authors.forename: Renato
authors.initials: R
authors.lastname: Peroni
authors.affiliation: Hospital de Olhos de Araraquara, Araraquara, Brazil.
authors.forename: José Augusto
authors.initials: JA
authors.lastname: Cardillo
authors.affiliation: School of Medicine of Ribeirão Preto, University of São Paulo, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto, Brazil.
authors.forename: Rubens Camargo
authors.initials: RC
authors.lastname: Siqueira
authors.affiliation: Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Ingrid Ursula
authors.initials: IU
authors.lastname: Scott
authors.affiliation: School of Medicine of Ribeirão Preto, University of São Paulo, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Messias
authors.affiliation: School of Medicine of Ribeirão Preto, University of São Paulo, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto, Brazil. Electronic address: rjorge@fmrp.usp.br.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jorge
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005583:Fourier Analysis; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069579:Ranibizumab; D012160:Retina / Q000473:pathology; D019233:Retreatment; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab